There are 636,120 ways to have post traumatic stress disorder

Posted on November 22, 2013

The latest version of the American Psychiatric Association's (APA) controversial diagnostic code - "the DSM-5" - continues the check-list approach used in previous editions. To receive a specific diagnosis, a patient must exhibit a minimum number of symptoms in different categories. One problem - this implies someone either has a mental illness or they don't.

To avoid missing people who ought to be diagnosed, over time the criteria for many conditions have expanded, and nowhere is this more apparent than in the case of post traumatic stress disorder (PTSD). Indeed, in their new analysis of the latest expanded diagnostic criteria for PTSD, Isaac Galatzer-Levy and Richard Bryant calculate that there are now 636,120 ways to be diagnosed with PTSD based on all the possible combinations of symptoms that would fulfil a diagnosis for this condition.

First defined as a distinct disorder in 1980, for many years PTSD was diagnosed based on a patient exhibiting a sufficient number of various symptoms in three categories: reexperiencing symptoms (e.g. flashbacks); avoidance and numbing symptoms (e.g. diminished interest in activities); and arousal symptoms (e.g. insomnia). For the latest version of the DSM, a new symptom category was introduced: alterations in mood and cognition (e.g. increased shame). This means a diagnosis of PTSD is now met according to the patient having a minimum of 8 of 19 possible symptoms across four categories (or criteria), so long as these appear after they witnessed or experienced an event involving actual or threatened harm.